The Four Issues In Health

April 12, 2013

I went to a lecture by Julio Frenk, Dean of the Faculty at the Harvard School of Public Health, this week in New York City. Dean Frenk said that there are four key challenges for the health care systems of the world. They are:

Infectious Diseases

Poverty

Unhealthy Behaviors Leading to Non-Communicable Diseases

Inept Health Care Systems

He spoke eloquently about behavior modification for infectious and non-communicable diseases. “Here is the main lesson we have derived from the designated driver program that seeks to stop drinking and driving. It is not enough to preach. It is not a lack of knowledge that we observe. Knowledge is a necessary but not sufficient factor to create change. You have to create incentives to change. A perfect example is raising taxes on tobacco; teens cannot afford expensive cigarettes.”

He went on to discuss the importance of good communications in preventing the spread of epidemics such as the avian flu. “We can use social networks to diagnose disease — a good example is a rise in searches on Google when an outbreak is beginning. And we need to speak through mainstream as well as social channels to tell those who show symptoms to see the doctor or stay at home.”

Frenk described a fundamental change in the education system that is coming from on-line learning. “We are experimenting with doing homework in the classroom through team problem-solving and simulation. You can listen to the lecture at home.” He said that the school is offering free on-line courses to the public. Fifty-five thousand signed up and 8,000 completed the entire program, including the exam. “We are at the point where online tools can instruct the masses in public health.”

He noted that the health establishment should be proud of itself in accomplishing a long-sought goal, longer life expectancy. “The aging population is a big achievement. But there is the fact of competing risks, meaning that you are going to die of something someday.”

Frenk was very tough on the obesity issue. “This is the first generation of Americans that will die younger than its parents. This can be attributed largely to obesity and sedentary lifestyles. We have to create an environment that encourages physical activity; let’s design cities to promote walking. But we also have to end subsidies that make it cheaper to buy an empty calorie. We should make it cheaper and easier to buy fresh produce.”

Several of our major clients are using the imminent implementation of “Obamacare” as a spur to change their health policies. They are putting good-for-you food into the company cafeteria. They are reducing health care premiums for those who regularly report on their blood pressure and weight plus take an annual physical exam. Edelman offers an employee who quits smoking $2,000 in cash plus a hotline to discuss stress at home or in the workplace. Chevron (an Edelman client) has an award-winning program to test workers for HIV-AIDS in developing markets. As Dean Frenk concluded, “It is going to take regulatory action, education and involvement by business to shape an environment in which the healthy choice is the easy one.”